Individual
MS. MICHELLE LEE WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1061 HARMON AVE, PEDIATRIC CLINIC, FORT STEWART, GA 31314-5641
(912) 435-5555
(912) 435-5954
Mailing address
1061 HARMON AVE, PEDIATRIC CLINIC, FORT STEWART, GA 31314-5611
(912) 435-5555
(912) 435-5954
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
047769
NC
Other
Enumeration date
11/17/2014
Last updated
11/17/2014
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